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AHIMA Wrap-Up: Domestic vs. International Transcription Still an Issue

Posted on October 19, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

All of the product literature I collected at the recent AHIMA show in Salt Lake City finally arrived in the mail the other day. As I sat sifting through all the pamphlets, brochures, case studies and white papers trying to remember why I had picked them up in the first place, one tag line in particular caught my eye: “Has your transcription seen more continents than you?”

Yes, there were plenty of technologies and services on hand relating to electronic medical records (EMRs) and electronic health records (EHR), depending on which term is your flavor of the week. But what really got my attention was the number of booths I went to that boasted transcription and coding services based right here in the good ole’ US of A, and their competitors that still internationally outsource these types of services.

Most booth reps I spoke with proudly told me that their services were located in the US. On the flip side, one company boasted that all of its services have been totally off-shored in order to meet customer demand for more competitive pricing. So what’s a provider to do?

I am, admittedly, new to the world of coding, and as this was my first AHIMA show, I was unaware of the schism that has developed in the world of domestic and international coding services. But, as a consumer that has been assisted – both competently and disastrously – by call center reps that I’m 99-percent sure were not located in the United States (despite their insistence on being located somewhere “in the Midwest”), I am aware of the consumer backlash that can result from a business’s decision to outsource its customer services.

I can only imagine, however, the pressures providers must feel when they are making decisions along these lines. Do they adhere to what their bottom line indicates is the best choice, which I assume means going international? Or do they stick with US-based companies to ensure that native English-speakers are picking up all the right nuances in documentation?

The brochure featuring the eye-catching tag line above continued its strong messaging with: “You’ve probably heard horror stories about what can happen when transcription services send work overseas. With language barriers, training deficiencies and rapidly changing regulations, mistakes – serious mistakes – are inevitable.”

Really? Inevitable is a pretty strong word. Is it a legitimate one to use in this circumstance?

A white paper from webmedx (now a part of Nuance), “Finance Leaders Rethink Transcription: Six Critical Criteria in a Changing Landscape,” provides a bit more insight into the issue: “Perhaps it was the black market sale of patient information in India …. Perhaps it was the worldwide economic meltdown and loss of U.S. jobs in 2009. Or maybe it is the pressure of tighter HIPAA regulations under ARRA’s HITECH Act. Whatever the cause, the effect is clear. Healthcare providers who sent medical transcription offshore in the past are bringing it back home.”

Are there any providers in the audience who’d care to speak to either side – why they chose to go domestic, or feel that the quality of transcription is just as good abroad? Has “cheap” become overrated?

Chime in with your comments below in answer to my question above.

HIM Professionals Focus on Job Creation, ICD-10 at AHIMA

Posted on October 5, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

A number of themes have been prevalent at this year’s AHIMA show, taking place this week in Salt Lake City. Healthcare information management professionals have a number of big priorities – the transition to ICD-10 being the most prevalent, at least from what I’ve seen on the show floor so far. Recruitment is a close second. With a number of colleges and healthcare systems present as exhibitors, it’s obvious there is a need for trained HIM professionals. In speaking with folks from the Region D Health IT Workforce Development Program, part of the Community College Consortia Program, which hopes to train more than 10,500 healthcare IT professionals by the end of this year, it is evident that there are resources out there to train folks, and they are willing to get the word out about it.

AHIMA has recognized this need for job creation. It announced at the show on Monday that it has created the HIM Jobs for America Initiative, and has entered into a public-private partnership with the Department of Health and Human Services and North Shore Medical Labs.

In announcing the initiative, Bill Rudman, vice president, educational visioning at AHIMA and executive director of the AHIMA Foundation, explained that “AHIMA wants to build a partnership with business, academia and the federal government to create the estimated 40,000 jobs required to properly build and maintain a national electronic health records initiative.”

As part of the initiative, AHIMA will provide six hours of free healthcare IT training to healthcare professionals in underserved communities, first focusing on physicians in small practices in North Carolina, Mississippi and Alabama. The program will provide 100 participants with EHR licenses for one year. North Shore will donate electronic health record software and services via Nortec Software, a provider of EHR technology, as well as medical billing and transcription services.

As I mentioned above, the transition to IDC-10 has been THE big theme in the exhibit hall. I’ve noticed solution after solution exhibited at booth after booth created to help physicians make the transition. As John Lynn mentioned in an earlier post, some companies are taking a light-hearted approach in marketing their ICD-10 solutions. Take QuadraMed, for example, which kept attendees happy Sunday night during the evening reception with special ICD-9 and ICD-10 cocktails. Or, as John mentioned last week, Conifer Health, which has quickly run out of its ICD-10 stickers.


All kidding aside, the transition to ICD-10 and the impact the new codes will have on patient care is no joke. Paula Lawlor, RHIA, President of Clinical Revenue Cycle Services HIM at Conifer, spoke with me briefly about what Conifer is doing in the area health information management and clinical revenue cycle services:

I’ll be walking the show floor today, and hope to have a wrap-up of EMR-related technologies for next week’s post.

Misunderstanding Social Media – “Twitter is nonsense and a 5 second ego boost”

Posted on October 4, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m currently attending the AHIMA conference. It’s my first time here and I’ve been quite pleased with the vendors that I’ve had a chance to meet. It’s been a really great event for me from that end. I have gotten a lot of interesting ideas and content about where the EHR and healthcare IT industry is moving.

Outside of other meetings that I have, I dropped into a social media session that they were having today. While the presenter spoke about a rather broad definition of social media, I was really taken back when he made the following comment about Twitter (which I had to tweet):

You can imagine the reaction from those that are part of #HITsm. I followed up with this tweet which better clarifies my view of what was said:

What a disservice to AHIMA to basically scare them out of using social media as opposed to talking about the benefits and how to manage the risks.

UPDATE: I was just reading this headline again and I’m still a bit shocked that he used these words. The “5 Second ego boost” part was particularly interesting for me. Anyone that’s put themselves out there on Twitter realizes that Twitter does little for your ego. It’s much better at tearing down egos than boosting them up. At least in many cases. It’s like readers of a blog. They are sure to keep you honest.

ICD-10 Controversy in Wall Street Journal

Posted on September 30, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed it, I wrote an entertaining (at least I thought it was) post about some of the amazingly specific ICD-10 codes that are out there. I’m headed to AHIMA which starts on Sunday and I’ve had a preview of a vendor, @coniferhealth, capitalizing on some of these codes with some stickers they’re handing out. I’ll embed a picture of one of these stickers at the bottom of this post.

Turns out that not everyone is happy with this light hearted approach to discussing what amounts to a major major shift from ICD-9 to ICD-10. The Wall Street Journal posted some of the responses they got to their original article. Here’s one sample response:

Having a different code for every single artery or the specific bone that’s fractured helps improve continuity of care. A patient who is hemorrhaging can get lifesaving care more quickly when the physician can immediately identify precisely where the broken suture is located. In addition, including the specification that the patient was “bitten by turtle” justifies the patient receiving additional tests or treatments, as turtles carry different bacteria than, say, parrots or turkeys. This and other tidbits of information will support more efficient and effective reimbursement processes.

The benefits we will derive from our global health-care community are tremendous. Once the U.S. finally transitions to ICD-10, we will again be able to share important data with every other civilized country

Although, not everyone is so serious. Arthur Broaderick, M.D. offered the following question, “Doctors closing their practices in droves; is there a code for that?”